E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Non-small Cell Lung Cancer |
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MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To compare gefitinib 250 mg with erlotinib 150 mg in terms of progression-free survival |
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E.2.2 | Secondary objectives of the trial |
- To compare gefitinib 250 mg with erlotinib 150 mg in terms of overall survival - To compare gefitinib 250 mg with erlotinib 150 mg in terms of objective response rate - To compare the safety and tolerability profile of daily doses of gefitinib 250 mg relative to that of erlotinib 150 mg. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1.Provision of informed consent. 2.Male or female, aged 18 years and over. 3.Histological confirmation of non-small cell lung carcinoma: adenocarcinoma (including bronchoalveolar), squamous cell carcinoma, large cell carcinoma or mixed (adenocarcinoma and squamous) or undifferentiated carcinoma. This may be from the initial diagnosis of NSCLC or subsequent biopsy. Cytology diagnosis only is not acceptable. 4.Locally advanced (Stage III) or metastatic (Stage IV) disease, not amenable to curative surgery or radiotherapy. 5.EGFR FISH + results from tumour tissue sample. Note: Tumour tissue sample provision for central analysis is a mandatory part of the screening procedures. The sample can be taken from archival diagnostic tissue from the original biopsy or a more recent biopsy. Both primary lesion and metastatic sites are acceptable. EGFR gene copy number will be assessed by fluorescent in-situ hybridization (FISH) using an approach based on the method described by Cappuzzo F et al 2005. The tumour will be considered FISH + if the test shows:- · High polysomy >4 copies in >40% of cells or · Gene amplification - Presence of tight gene clusers and a >2 gene/chromosome ratio per cell or - >15 copies of EGFR/cell in >10% of analysed cells. 6.Not considered to require palliative chest radiotherapy at the time of study entry or in the near future. 7.Treatment with one or two prior chemotherapy regimen. · Patients who received one previous line of single agent chemotherapy for advanced disease are eligible. · Patients who received adjuvant chemotherapy with curative intent and who have recurrence of their disease within 12 months of completing chemotherapy are also eligible. 8.WHO Performance status (PS) 0 to 2. 9.Measurable disease according to RECIST criteria with at least one measurable lesion not previously irradiated. · Lesions that have been irradiated in the advanced setting cannot be included as sites of measurable disease unless clear tumour progression has been documented in these lesions since the end of radiation therapy. 10.Estimated life expectancy of at least 12 weeks. 11.Patients must be willing to complete the FACT-L questionnaire.
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E.4 | Principal exclusion criteria |
1.Known hypersensitivity to gefitinib or any of the excipients of this product. 2.Known hypersensitivity to erlotinib or any of the excipients of this product. 3.Prior therapy with EGFR TK inhibitors (HER-1 receptor inhibitors/small molecule or monoclonal antibody therapy). 4.Newly diagnosed central nervous system (CNS) metastases that have not yet been definitively treated with surgery and/or radiation. Patients with previously diagnosed and treated CNS metastases or spinal cord compression may be considered if they have evidence of clinically stable disease and are not receiving steroid therapy. (See below for anticonvulsant medications that are not permitted). 5.Less than 30 days since completion of prior wide field chest radiotherapy or persistence of any radiotherapy related toxicity *. 6.* The patient may have local palliative radiation to a non-chest site for the management of tumour-related symptoms. 7.Any unresolved chronic toxicity greater then CTCAE grade 2 from previous anti-cancer therapy. 8.Other co-existing malignancies or malignancies diagnosed within the last 5 years with the exception of basal cell carcinoma or cervical cancer in situ. 9.Any evidence of clinically active interstitial lung disease (patients with chronic, stable, radiographic changes who are asymptomatic need to be excluded). 10.Concomitant use of phenytoin, carbamazepine, rifampicin, rifabutin, barbiturates or St John’s Wort (Hypercium). 11.Serum bilirubin greater than 1.5 times the upper limit of reference range (ULRR). 12.Alanine amino transferase (ALT) or aspartate aminotransferase (AST) greater than 2.5 times the ULRR if no demonstrable liver metastases or greater than 5 times the ULRR in the presence of liver metastases. 13.Any significant ophthalmologic abnormality, especially severe dry eye syndrome, kerato-conjunctivitis sicca, Sjorgen syndrome, severe exposure keratitis or any other disorder likely to increase the risk of corneal epithelial lesions. 14.As judged by the Investigator, any evidence of severe or uncontrolled systemic disease (e.g., unstable or uncompensated respiratory, cardiac, including arrhythmias, hepatic, or renal disease). 15.Uncontrolled vomiting or diarrhoea, or evidence of any other significant clinical disorder or laboratory finding that makes it undesirable for the patient to participate in the study. 16.Pregnancy or breast-feeding (women of child-bearing potential) or patients of childbearing potential with a positive pregnancy test prior to receiving trial medication. Women of childbearing potential must practice acceptable methods of birth control to prevent pregnancy. 17.Males must be willing to practice acceptable methods of birth control whilst taking study medication to prevent pregnancy of a partner. 18.Previous enrolment or randomisation to treatment in the present study. 19.Involvement in the planning and conduct of the study (applies to both AstraZeneca staff or staff at the investigational site). 20.Treatment with a non-approved or investigational drug within 30 days before Day 1 of study treatment.
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E.5 End points |
E.5.1 | Primary end point(s) |
Progression free survival (PFS) |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | 3 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 3 |